Clinical study on diagnosis of myocardial fibrosis by soluble suppression of tumorigenicity 2, galectin-3 combined with magnetic resonance multimodality / 中国医师进修杂志

ABSTRACT

Objective:To explore the application value of soluble tumor suppressor 2 (SST2), galectin-3 combined with magnetic resonance multimodality in the diagnosis of myocardial fibrosis.Methods:The clinical data of 88 patients with cardiomyopathy from January 2017 to December 2019 in Handan Central Hospital of Hebei Province were retrospectively analyzed as the experimental group, and 100 healthy people in the same period were selected as the control group. According to the results of cardiac magnetic resonance imaging (CMRI)-late gadolinium enhanced (LGE), the patients with cardiomyopathy were divided into LGE positive and LGE negative. The arrhythmia rate was evaluated by ambulatory electrocardiogram. The New York Heart Association (NYHA) cardiac function grade was recorded. The left ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVEDD) were detected by echocardiography. The SST2, galectin-3 and N-terminal pro-brain natriuretic peptide (NT-proBNP) were detected by enzyme-linked immunosorbent assay (ELISA). The receiver operating characteristic (ROC) curve was drawn to analyze the efficacy of SST2 and Galectin-3 in predicting myocardial fibrosis in patients with cardiomyopathy.Results:CMRI-LGE results of 88 patients with cardiomyopathy showed that LGE was positive in 42 cases and negative in 46 cases. The arrhythmia rate, LVEDD, SST2 and galectin-3 in experimental group were significantly higher than those in control group 67.05% (59/88) vs. 2.00% (2/100), (46.55 ± 5.99) mm vs. (27.92 ± 2.05) mm, (61.83 ± 10.57) μg/L vs. (24.99 ± 7.69) μg/L and (18.65 ± 3.39) μg/L vs. (7.12 ± 1.33) μg/L, the LVEF was significantly lower than that in control group (55.11 ± 8.36)% vs. (68.83 ± 9.45)%, and there were statistical differences ( P<0.01). The arrhythmia rate, NYHA cardiac function grade, LVEDD, SST2 and galectin-3 in patients with LGE positive were significantly higher than those in patients with LGE negative 88.10% (37/42) vs. 47.83% (22/46), (3.10 ± 0.53) grade vs. (2.11 ± 0.61) grade, (48.88 ± 5.95) mm vs. (44.41 ± 5.24) mm, (65.58 ± 11.73) μg/L vs. (58.40 ± 8.10) μg/L and (21.00 ± 2.72) μg/L vs. (16.51 ± 2.39) μg/L, the LVEF was significantly lower than that in patients with LGE negative (52.15 ± 8.23)% vs. (57.82 ± 7.60)%, and there were statistical differences ( P<0.01). ROC curve analysis result showed that the optimal critical values of serum SST2 and galectin-3 for predicting myocardial fibrosis in patients with cardiomyopathy were 65.07 μg/L and 18.46 μg/L, the area under the curve was 0.714 (95% CI 0.604 to 0.825, P = 0.001) and 0.894 (95% CI 0.828 to 0.960, P = 0.001), the sensitivity was 61.9% and 85.7%, and the specificity was 80.4% and 82.6%. Conclusions:Magnetic resonance multimodality has a good ability in detecting myocardial fibrosis, and serum SST2 and galectin-3 have good predictive value for myocardial fibrosis. SST2 and galectin-3 combined with magnetic resonance multimodality has important clinical significance in the diagnosis of myocardial fibrosis.